Senate Bill S2008

Signed By Governor
2021-2022 Legislative Session

Requires specification between partial approval of medical claims and full denial of medical claims on written notices to an insurer

download bill text pdf

Sponsored By

Archive: Last Bill Status - Signed by Governor

  • Introduced
    • In Committee Assembly
    • In Committee Senate
    • On Floor Calendar Assembly
    • On Floor Calendar Senate
    • Passed Assembly
    • Passed Senate
  • Delivered to Governor
  • Signed By Governor

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Bill Amendments

co-Sponsors

2021-S2008 - Details

See Assembly Version of this Bill:
A1677
Law Section:
Insurance Law
Laws Affected:
Amd §3224-a, Ins L
Versions Introduced in 2019-2020 Legislative Session:
S7159, A9085

2021-S2008 - Summary

Requires specification between partial approval of medical claims or payments and full denial of medical claims or payments on written notices to an insurer or an organization or corporation licensed or certified.

2021-S2008 - Sponsor Memo

2021-S2008 - Bill Text download pdf 

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2008
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                             January 16, 2021
                                ___________
 
 Introduced   by   Sens.   JACKSON,  BENJAMIN,  RAMOS,  SALAZAR,  BIAGGI,
   GOUNARDES, KRUEGER, LIU, RIVERA, SEPULVEDA -- read twice  and  ordered
   printed,  and  when printed to be committed to the Committee on Insur-
   ance
 
 AN ACT to amend the insurance law, in relation to  requiring  specifica-
   tion  between  partial  approval  of  medical  claims  and a denial of
   medical claims on written notices to an insurer
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Subsection (b) of section 3224-a of the insurance law, as
 amended by section 8 of part YYY of chapter 56 of the laws of  2020,  is
 amended to read as follows:
   (b) In a case where the obligation of an insurer or an organization or
 corporation  licensed  or  certified  pursuant to article forty-three or
 forty-seven of this chapter or article forty-four of the  public  health
 law  to  pay a claim or make a payment for health care services rendered
 is not reasonably clear due to a good faith dispute regarding the eligi-
 bility of a person for coverage, the liability  of  another  insurer  or
 corporation  or organization for all or part of the claim, the amount of
 the claim, the benefits covered under a contract or  agreement,  or  the
 manner in which services were accessed or provided, an insurer or organ-
 ization  or corporation shall pay any undisputed portion of the claim in
 accordance with this subsection and  notify  the  policyholder,  covered
 person  or  health care provider in writing, and through the internet or
 other electronic means for claims submitted in that manner, within thir-
 ty calendar days of the receipt of the claim:
   (1) WHETHER THE CLAIM OR BILL HAS BEEN DENIED OR PARTIALLY APPROVED;
   (2) WHICH CLAIM OR MEDICAL PAYMENT that it is  not  obligated  to  pay
 [the  claim  or  make the medical payment,] stating the specific reasons
 why it is not liable; [or
   (2)] AND

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

co-Sponsors

2021-S2008A - Details

See Assembly Version of this Bill:
A1677
Law Section:
Insurance Law
Laws Affected:
Amd §3224-a, Ins L
Versions Introduced in 2019-2020 Legislative Session:
S7159, A9085

2021-S2008A - Summary

Requires specification between partial approval of medical claims or payments and full denial of medical claims or payments on written notices to an insurer or an organization or corporation licensed or certified.

2021-S2008A - Sponsor Memo

2021-S2008A - Bill Text download pdf 

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  2008--A
     Cal. No. 570
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                             January 16, 2021
                                ___________
 
 Introduced   by   Sens.   JACKSON,  BENJAMIN,  RAMOS,  SALAZAR,  BIAGGI,
   GOUNARDES, KRUEGER, LIU, RIVERA, SEPULVEDA -- read twice  and  ordered
   printed,  and  when printed to be committed to the Committee on Insur-
   ance -- reported favorably from said committee, ordered to  first  and
   second report, ordered to a third reading, passed by Senate and deliv-
   ered  to  the Assembly, recalled, vote reconsidered, restored to third
   reading, amended and ordered reprinted, retaining  its  place  in  the
   order of third reading
 
 AN  ACT  to amend the insurance law, in relation to requiring specifica-
   tion between partial approval  of  medical  claims  and  a  denial  of
   medical claims on written notices to an insurer
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subsection (b) of section 3224-a of the insurance  law,  as
 amended  by  section 8 of part YYY of chapter 56 of the laws of 2020, is
 amended to read as follows:
   (b) In a case where the obligation of an insurer or an organization or
 corporation licensed or certified pursuant  to  article  forty-three  or
 forty-seven  of  this chapter or article forty-four of the public health
 law to pay a claim or make a payment for health care  services  rendered
 is not reasonably clear due to a good faith dispute regarding the eligi-
 bility  of  a  person  for coverage, the liability of another insurer or
 corporation or organization for all or part of the claim, the amount  of
 the  claim,  the  benefits covered under a contract or agreement, or the
 manner in which services were accessed or provided, an insurer or organ-
 ization or corporation shall pay any undisputed portion of the claim  in
 accordance  with  this  subsection  and notify the policyholder, covered
 person or health care provider in writing, and through the  internet  or
 other electronic means for claims submitted in that manner, within thir-
 ty calendar days of the receipt of the claim:
   (1) WHETHER THE CLAIM OR BILL HAS BEEN DENIED OR PARTIALLY APPROVED;
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets

co-Sponsors

2021-S2008B (ACTIVE) - Details

See Assembly Version of this Bill:
A1677
Law Section:
Insurance Law
Laws Affected:
Amd §3224-a, Ins L
Versions Introduced in 2019-2020 Legislative Session:
S7159, A9085

2021-S2008B (ACTIVE) - Summary

Requires specification between partial approval of medical claims or payments and full denial of medical claims or payments on written notices to an insurer or an organization or corporation licensed or certified.

2021-S2008B (ACTIVE) - Sponsor Memo

2021-S2008B (ACTIVE) - Bill Text download pdf 

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  2008--B
     Cal. No. 570
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                             January 16, 2021
                                ___________
 
 Introduced   by   Sens.   JACKSON,  BENJAMIN,  RAMOS,  SALAZAR,  BIAGGI,
   GOUNARDES, KRUEGER, LIU, RIVERA, SEPULVEDA -- read twice  and  ordered
   printed,  and  when printed to be committed to the Committee on Insur-
   ance -- reported favorably from said committee, ordered to  first  and
   second report, ordered to a third reading, passed by Senate and deliv-
   ered  to  the Assembly, recalled, vote reconsidered, restored to third
   reading, amended and ordered reprinted, retaining  its  place  in  the
   order  of  third  reading  --  repassed by Senate and delivered to the
   Assembly, recalled, vote  reconsidered,  restored  to  third  reading,
   amended  and  ordered  reprinted,  retaining its place in the order of
   third reading
 
 AN ACT to amend the insurance law, in relation to  requiring  specifica-
   tion  between  partial  approval  of  medical  claims  and a denial of
   medical claims on written notices to an insurer
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Subsection (b) of section 3224-a of the insurance law, as
 amended by section 8 of part YY of chapter 56 of the laws  of  2020,  is
 amended to read as follows:
   (b) In a case where the obligation of an insurer or an organization or
 corporation  licensed  or  certified  pursuant to article forty-three or
 forty-seven of this chapter or article forty-four of the  public  health
 law  to  pay a claim or make a payment for health care services rendered
 is not reasonably clear due to a good faith dispute regarding the eligi-
 bility of a person for coverage, the liability  of  another  insurer  or
 corporation  or organization for all or part of the claim, the amount of
 the claim, the benefits covered under a contract or  agreement,  or  the
 manner in which services were accessed or provided, an insurer or organ-
 ization  or corporation shall pay any undisputed portion of the claim in
 accordance with this subsection and  notify  the  policyholder,  covered
 person  or  health care provider in writing, and through the internet or
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets

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